Prevalence of Tobacco Use in Urban,Semi Urban and Rural Areas in and around Chennai City,India

Background

Tobacco use leads to many health complications and is a risk factor for the occurrence of cardio vascular diseases, lung and oral cancers, chronic bronchitis etc. Almost 6 million people die from tobacco-related causes every year. This study was conducted to measure the prevalence of tobacco use in three different areas around Chennai city, south India.

Methods

A survey of 7510 individuals aged > = 15 years was undertaken covering Chennai city (urban), Ambattur (semi-urban) and Sriperumbudur (rural) taluk. Details on tobacco use were collected using a questionnaire adapted from both Global Youth Tobacco Survey and Global Adults Tobacco Survey.

Results

The overall prevalence of tobacco use was significantly higher in the rural (23.7%) compared to semi-urban (20.9%) and urban (19.4%) areas (P value <0.001) Tobacco smoking prevalence was 14.3%, 13.9% and 12.4% in rural, semi-urban and urban areas respectively. The corresponding values for smokeless tobacco use were 9.5%, 7.0% and 7.0% respectively. Logistic regression analysis showed that the odds of using tobacco (with smoke or smokeless forms) was significantly higher among males, older individuals, alcoholics, in rural areas and slum localities. Behavioural pattern analysis of current tobacco users led to three groups (1) those who were not reached by family or friends to advice on harmful effects (2) those who were well aware of harmful effects of tobacco and even want to quit and (3) those are exposed to second hand/passive smoking at home and outside.

Conclusions

Tobacco use prevalence was significantly higher in rural areas, slum dwellers, males and older age groups in this region of south India. Women used mainly smokeless tobacco. Tobacco control programmes need to develop strategies to address the different subgroups among tobacco users. Public health facilities need to expand smoking cessation counseling services as well as provide pharmacotherapy where necessary.     

Tick-Borne Rickettsioses,Neglected Emerging Diseases in Rural Senegal

Background

Rickettsioses are one of the most important causes of systemic febrile illness among travelers from developed countries, but little is known about their incidence in indigenous populations, especially in West Africa.

Methodology/Principal Findings

Overall seroprevalence evaluated by immunofluorescence using six rickettsial antigens (spotted fever and typhus group) in rural populations of two villages of the Sine-Saloum region of Senegal was found to be 21.4% and 51% for spotted fever group rickettsiae for Dielmo and Ndiop villages, respectively. We investigated the role of tick-borne rickettsiae as the cause of acute non-malarial febrile diseases in the same villages. The incidence of rickettsial DNA in 204 blood samples from 134 (62M and 72F) febrile patients negative for malaria was studied. DNA extracted from whole blood was tested by two qPCR systems. Rickettsial DNA was found in nine patients, eight with Rickettsia felis (separately reported). For the first time in West Africa, Rickettsia conorii was diagnosed in one patient. We also tested 2,767 Ixodid ticks collected in two regions of Senegal (Niakhar and Sine-Saloum) from domestic animals (cows, sheep, goats, donkeys and horses) by qPCR and identified five different pathogenic rickettsiae. We found the following: Rickettsia aeschlimannii in Hyalomma marginatum rufipes (51.3% and 44.8% in Niakhar and Sine-Saloum region, respectively), in Hyalomma truncatum (6% and 6.8%) and in Rhipicephalus evertsi evertsi (0.5%, only in Niakhar); R. c. conorii in Rh. e. evertsi (0.4%, only in Sine-Saloum); Rickettsia massiliae in Rhipicephalus guilhoni (22.4%, only in Niakhar); Rickettsia sibirica mongolitimonae in Hyalomma truncatum (13.5%, only in Sine-Saloum); and Rickettsia africae in Rhipicephalus evertsi evertsi (0.7% and 0.4% in Niakhar and Sine-Saloum region, respectively) as well as in Rhipicephalus annulatus (20%, only in Sine-Saloum). We isolated two rickettsial strains from H. truncatum: R. s. mongolitimonae and R. aeschlimannii.

Conclusions/Significance

We believe that together with our previous data on the high prevalence of R. africae in Amblyomma ticks and R. felis infection in patients, the presented results on the distribution of pathogenic rickettsiae in ticks and the first R. conorii case in West Africa show that the rural population of Senegal is at risk for other tick-borne rickettsioses, which are significant causes of febrile disease in this area.     

A Survey of Dog Populations in Urban and Rural Areas of Yucatan,Mexico

ABSTRACT

A survey in a major Mexican city (Merida) and three rural communities was conducted to generate information regarding the size and structure of the owned-dog populations and people's opinions about the dogs and how they took care of them. Household characteristics and dog population size, health and reproductive issues were compared between the two kinds of communities: urban and rural. A telephone survey was conducted in Merida city whereas personal interviews were used in the rural communities. Local veterinarians were also interviewed to evaluate their influence on the dog populations in Merida city. The ratio of people to dogs was 3.4:1 in the city, and 1.7:1 to 4.6:1 in the different rural communities. In general it was more common to find a dog-owning household in the city of Merida (72.8%) than in the rural areas (63.6%, 65.5% and 71.1%), and in the city more households had adequate fences to restrain dogs. Larger families were more likely to own a dog than small families. Households of medium socio-economic status had a significantly higher probability of owning a dog than households of low or high socio-economic status. Of the dogs in the city, 90.1% were vaccinated against rabies compared with 62.3% of the dogs in the rural communities. Most animals were intact; the frequency of neutering/spaying was 3.1% in Merida and 1.8% in the rural communities. Few private veterinary practitioners were involved in the control of dog overpopulation. It is concluded that dogs are popular pets both in urban and rural Yucatan. People's opinions about dogs and the level of supervision varied with socio-economic status, and people in the city provided better food, shelter and preventive medicine. The veterinary practitioners did little to promote the control of dog breeding or to reduce the relinquishing of unwanted dogs in the city. Better client education and the promotion of sterilization of pets at low cost would improve the situation.     

Rural Bushmeat Consumption Within Multiple-use Protected Areas: Qualitative Evidence from Southwest Madagascar

Ensuring the sustainability of bushmeat consumption is critical for both biodiversity conservation and poverty alleviation in tropical developing countries, yet we know little about the role of hunting and bushmeat consumption in the daily lives of rural communities. We provide the first detailed, qualitative examination of bushmeat hunting activities conducted by a rural community within one of Madagascar’s new, multiple-use protected areas, in order to inform appropriate management strategies. Results suggest that most species are eaten, but that few are favoured above domestic meat. Hunting is generally a secondary pursuit, carried out opportunistically during the course of other activities, although its importance does increase in times of food stress. Management focused on increasing domestic meat availability and directing hunting effort away from sensitive species may improve the sustainability of hunting, but development interventions to reduce forest dependence may be required to promote conservation and poverty alleviation simultaneously.     

Canada Goose Survival and Recovery Rates in Urban and Rural Areas of Iowa,USA

Once extirpated from much of their North American range, temperate-breeding Canada geese (Branta canadensis maxima) have reached high abundance. As a result, focus has shifted from restoration to managing harvest and addressing human-goose conflict. Conflict persists or is increasing in urban areas throughout the Mississippi Flyway. Managers need more information regarding demographic rates to determine how hunting affects geese breeding in urban areas and what management actions may be required to achieve management goals. We estimated survival, dead recovery, live recapture, and fidelity probabilities using data from 77,872 Canada geese banded in Iowa, USA, during 1999–2019 using Burnham joint live-dead band recovery models. Factors predicted to affect parameters in candidate models included age (juvenile, subadult, adult), banding site (urban, rural), time, trend, harvest regulation index, and winter severity index. We predicted Canada geese banded in urban areas would have higher survival and lower dead recovery rates than geese banded at rural sites. The top model indicated support for age and banding site effects, and trends in survival and recovery rate (Brownie parameterization). Adult survival was similar for urban (0.75; range = 0.60–0.92) and rural (0.75; range = 0.66–0.82) geese and relatively constant across years. Mean juvenile survival was lower in urban (0.74; range = 0.48–0.93) than rural (0.85; range = 0.68–0.92) areas. Survival increased for urban-banded juveniles and recovery rates increased during liberalization of harvest regulations and decreased after regulations stabilized. Recovery rates of subadults increased for the urban and rural groups. Our results suggest Canada geese breeding in urban areas contribute to harvest and specialized regulations can affect these populations. Harvest regulations in place during our analysis may not have reached a threshold required to observe substantial changes in survival. Current human-goose conflict in urban areas suggests survival has not decreased to a level required to completely address conflict via reduction in goose abundance. Managers may consider additional liberalization of harvest regulations and monitoring via banding to determine to what degree hunter harvest contributes to reducing human-goose conflict and what additional management actions will be required to achieve goals. © 2020 The Wildlife Society.     

Nutritional Status in Community-Dwelling Elderly in France in Urban and Rural Areas

Malnutrition is a frequent condition in elderly people, especially in nursing homes and geriatric wards. Its frequency is less well known among elderly living at home. The objective of this study was to describe the nutritional status evaluated by the Mini Nutritional Assessment (MNA) of elderly community-dwellers living in rural and urban areas in France and to investigate its associated factors.

Methods

Subjects aged 65 years and over from the Approche Multidisciplinaire Intégrée (AMI) cohort (692 subjects living in a rural area) and the Three-City (3C) cohort (8,691 subjects living in three large urban zones) were included. A proxy version of the MNA was reconstructed using available data from the AMI cohort. Sensitivity and specificity were used to evaluate the agreement between the proxy version and the standard version in AMI. The proxy MNA was computed in both cohorts to evaluate the frequency of poor nutritional status. Factors associated with this state were investigated in each cohort separately.

Results

In the rural sample, 38.0% were females and the mean age was 75.5 years. In the urban sample, 60.3% were females and the mean age was 74.1 years. Among subjects in living in the rural sample, 7.4% were in poor nutritional status while the proportion was 18.5% in the urban sample. Female gender, older age, being widowed, a low educational level, low income, low body mass index, being demented, having a depressive symptomatology, a loss of autonomy and an intake of more than 3 drugs appeared to be independently associated with poor nutritional status.

Conclusion

Poor nutritional status was commonly observed among elderly people living at home in both rural and urban areas. The associated factors should be further considered for targeting particularly vulnerable individuals.     

Epidemiology of Pathogenic Enterobacteria in Humans,Livestock, and Peridomestic Rodents in Rural Madagascar

Background

Among the families of enteric bacteria are globally important diarrheal agents. Despite their potential for zoonotic and environmental transmission, few studies have examined the epidemiology of these pathogens in rural systems characterized by extensive overlap among humans, domesticated and peridomestic animals. We investigated patterns of infection with Enterotoxigenic Escherichia coli, Shigella spp., Salmonella enterica, Vibrio cholerae, and Yersinia spp. (enterocolitica, and pseudotuberculosis) in Southeastern Madagascar where the potential for the aforementioned interactions is high. In this pilot project we conducted surveys to examine behaviors potentially associated with risk of infection and if infection with specific enterobacteria species was associated with diarrheal disease.

Methodology/Principal Findings

PCR was conducted on DNA from human, livestock, and rodent fecal samples from three villages. Overall, human prevalence was highest (77%), followed by rodents (51%) and livestock (18%). Rodents were ∼2.8 times more likely than livestock to carry one of the bacteria. The incidence of individual species varied between villages, with the observation that, E. coli and Shigella spp. were consistently associated with co-infections. As an aggregate, there was a significant risk of infection linked to a water source in one village. Individually, different pathogens were associated with certain behaviors, including: those who had used medication, experienced diarrhea in the past four weeks, or do not use toilets.

Conclusions/Significance

Different bacteria were associated with an elevated risk of infection for various human activities or characteristics. Certain bacteria may also predispose people to co-infections. These data suggest that a high potential for transmission among these groups, either directly or via contaminated water sources. As these bacteria were most prevalent in humans, it is possible that they are maintained in humans and that transmission to other species is infrequent. Further studies are needed to understand bacterial persistence, transmission dynamics, and associated consequences in this and similar systems.     

Prevalence of Hypertension in Rural Areas of China: A Meta-Analysis of Published Studies

Background

Hypertension is one of the leading causes of disease burden across the world. In China, the latest nationwide survey of prevalence of hypertension was ten year ago, and data in rural areas is little known. More information about hypertension prevalence could help to improve overall antihypertensive health care. We aimed to estimate the pooled prevalence of hypertension in rural areas of China.

Methods

Comprehensive electronic searches of PubMed, Web of Knowledge, Chinese Web of Knowledge, Wangfang, Weipu and SinoMed databases were conducted to identify any study in each database published from January 1, 2004 to December 31, 2013, reporting the prevalence of hypertension in Chinese rural areas. Prevalence estimates were stratified by age, area, sex, publication year, and sample size. All statistical calculations were made using the Stata Version 11.0 (College Station, Texas) and Statsdirect Version 2.7.9.

Results

We identified 124 studies with a total population of 3,735,534 in the present meta-analysis. Among people aged 18 years old in Chinese rural areas, the summarized prevalence is 22.81% (19.41%–26.41%). Subgroup analysis shows the following results: for male 24.46% (21.19%–27.89%, for female 22.17% (18.25%–26.35%). For 2004–2006: 18.94% (14.41%–23.94%), for 2007–2009, 21.24% (15.98%–27.01%) for 2010–2013: 26.68%, (20.79%–33.02%). For Northern region 25.76% (22.36%–29.32%), for Southern region 19.30%, (15.48%–24.08%).

Conclusions

The last decade witnessed the growth in prevalence of hypertension in rural areas of China compared with the fourth national investigation, which has climbed the same level as the urban area. Guidelines for screening and treatment of hypertension in rural areas need to be given enough attention.     

Phytol,a Diterpene Alcohol from Chlorophyll,as a Drug against Neglected Tropical Disease Schistosomiasis Mansoni

Background

Schistosomiasis is a major endemic disease that affects hundreds of millions worldwide. Since the treatment and control of this parasitic disease rely on a single drug, praziquantel, it is imperative that new effective drugs are developed. Here, we report that phytol, a diterpene alcohol from chlorophyll widely used as a food additive and in medicinal fields, possesses promising antischistosomal properties in vitro and in a mouse model of schistosomiasis mansoni.

Methods and findings

In vitro, phytol reduced the motor activity of worms, caused their death and confocal laser scanning microscopy analysis showed extensive tegumental alterations in a concentration-dependent manner (50 to 100 µg/mL). Additionally, phytol at sublethal doses (25 µg/mL) reduced the number of Schistosoma mansoni eggs. In vivo, a single dose of phytol (40 mg/kg) administered orally to mice infected with adult S. mansoni resulted in total and female worm burden reductions of 51.2% and 70.3%, respectively. Moreover, phytol reduced the number of eggs in faeces (76.6%) and the frequency of immature eggs (oogram pattern) was significantly reduced. The oogram also showed increases in the proportion of dead eggs. Confocal microcopy studies revealed tegumental damage in adult S. mansoni recovered from mice, especially in female worms.

Conclusions

The significant reduction in parasite burden by this chlorophyll molecule validates phytol as a promising drug and offers the potential of a new direction for chemotherapy of human schistosomiasis. Phytol is a common food additive and nonmutagenic, with satisfactory safety. Thus, phytol has potential as a safe and cost-effective addition to antischistosomal therapy.     

北京城乡医患信任水平比较研究

目的 从医患双方的视角比较北京城乡医患信任水平。方法 对北京市农村H区3个乡镇12个村和城市3家医院的医生和患者进行实地观察。结果 医患双方对城乡医患信任水平评价均值均高于3.6分。经统计学检验,城乡患者对城乡医患信任水平评价存在显著差异（F=5.050,P=0.008）,城市医院医患双方对医患信任水平评价存在显著差异（t=3.16,P=0.002）。结论 影响患者对城乡医患信任水平评价的因素主要有城乡医疗机构的服务功能、服务水平、设备设施、服务态度等。     

Major Factors Affecting the Distribution of Anuran Communities in the Urban,Suburban and Rural Areas of Shanghai,China

There is a dearth of information on the effects of landscape and microhabitat variables on the distribution of anurans in areas of rapid urban development, in both tropical and subtropical regions. Therefore, we studied 24 wetlands sites from the center of Shanghai city, China extending outward to rural areas. Sampling was performed from May through July 2014. Urbanization was categorized by the proportion of hard ground cover. Transect sampling and ‘calling' surveys were used to investigated the richness and density of anurans; microhabitat factors were recorded simultaneously. One-way analysis of variance and Kruskal–Wallis tests were conducted to analyze differences of total density, species richness and density of individual anuran species in the three urbanization levels; redundancy analysis was carried out on the relationship between anuran density and environmental variables. Species richness was lowest in the areas where the proportion of hard ground cover was 80%, and the total density of anurans was highest in the areas where coverage of the hard ground cover was 30%. We recorded five species belonging to four genera and four families and an individual anuran species that had varied representations in urban environments. Beijing gold-striped pond frogs(Pelophylax plancyi) and Zhoushan toads(Bufo gargarizans) appeared to be well adapted to the Shanghai metropolis. Large water environments and aquatic vegetation(floating-leaves and emergent vegetation) were indicators of the presence of Beijing gold-striped pond frogs. The density of black-spotted pond frog(Pelophylax nigromaculatus) was at the lowest density in the areas where hard ground coverage was 80%, and tended to prefer larger bodies of water. Hong Kong rice-paddy frogs(Fejervarya multistriata) and ornamented pygmy frogs(Microhyla achatina) both suffered severely from cropland loss due to urban development. Bare land around breeding grounds was important for Hong Kong rice-paddy frogs, since it usually chooses mud coast caves for hibernation.     

Chinese Herbal Therapy and Western Drug Use,Belief and Adherence for Hypertension Management in the Rural Areas of Heilongjiang Province,China

Background

Traditional Chinese medicine (TCM) including Chinese herbal therapy has been widely practiced in China. However, little is known about Chinese herbal therapy use for hypertension management, which is one of the most prevalent chronic conditions in China. Thus we described Chinese herbal therapy and western drug users, beliefs, hypertension knowledge, and Chinese herbal and western drug adherence and determinants of Chinese herbal therapy use among patients with hypertension in rural areas of Heilongjiang Province, China.

Methodology and Principal Findings

This face-to-face cross sectional survey included 665 hypertensive respondents aged 30 years or older in rural areas of Heilongjiang Province, China. Of 665 respondents, 39.7% were male, 27.4% were aged 65 years or older. At the survey, 14.0% reported using Chinese herbal therapy and 71.3% reported using western drug for hypertension management. A majority of patients had low level of treatment adherence (80.6% for the Chinese herbal therapy users and 81.2% for the western drug users). When respondents felt that their blood pressure was under control, 72.0% of the Chinese herbal therapy users and 69.2% of the western drug users sometimes stopped taking their medicine. Hypertensive patients with high education level or better quality of life are more likely use Chinese herbal therapy.

Conclusions and Significance

Majority of patients diagnosed with hypertension use western drugs to control blood pressure. Chinese herbal therapy use was associated with education level and quality of life.     

Magnitude of Cardiovascular Risk Factors in Rural and Urban Areas in Benin: Findings from a Nationwide Steps Survey

ObjectiveTo describe and compare the prevalences of CVRF in urban and rural populations of Benin.MethodsSubjects were drawn from participants in the Benin Steps survey, a nationwide cross-sectional study conducted in 2008 using the World Health Organisation (WHO) stepwise approach to surveillance of chronic disease risk factors. Subjects aged above 24 and below 65 years were recruited using a five-stage random sampling process within households. Sociodemographic data, behavioral data along with medical history of high blood pressure and diabetes mellitus were collected in Step 1. Anthropometric parameters and blood pressure were measured in Step 2. Blood glucose and cholesterol levels were measured in Step 3. CVRF were defined according to WHO criteria. The prevalences of CVRF were assessed and the relationships between each CVRF and the area of residence (urban or rural), were evaluated using multivariable logistic regression models.ResultsOf the 6762 subjects included in the study, 2271 were from urban areas and 4491 were from rural areas. High blood pressure was more prevalent in urban than in rural areas, 29.9% (95% confidence intervals (95% CI): 27.4, 32.5) and 27.5% (95% CI: 25.6, 29.5) respectively, p = 0.001 (p-value after adjustment for age and gender). Obesity was more prevalent in urban than in rural areas, 16.4% (95% CI: 14.4, 18.4) and 5.9% (95% CI: 5.1, 6.7), p<0.001. Diabetes was more prevalent in urban than in rural areas, 3.3% (95% CI: 2.1, 4.5) and 1.8% (95% CI: 1.2, 2.4), p = 0.004. Conversely, daily tobacco smoking was more prevalent in rural than in urban areas, 9.3% (95% CI: 8.1, 10.4) and 4.3% (95% CI: 3.1, 5.6), p<0.001. No differences in raised blood cholesterol were noted between the two groups.ConclusionAccording to our data, CVRF are prevalent among adults in Benin, and variations between rural and urban populations are significant. It may be useful to take account of the heterogeneity in the prevalence of CVRF when planning and implementing preventive interventions.